ask dr. mindy golden of ucff about the newest breakthroughs in detecting breast cancer and's now study that may change breast cancer treatment. and hear how one bay area organization helps women escape domestic violence. i'm susan sykora and that is on bay area focus next.

welcome to bay area focus. i'm susan sykora. october is breast cancer awareness month. a study reveals key facts, facts that can lead to more precise breast cancer treatments. to explain, we welcome back dr. mindy goldman. she's director of the women's cancer care program at ucsf and has a special interest in women with breast cancer as well as alternative therapies for menopausal symptoms. the program means the long-term

needs of breast cancer patients. welcome back. good to have you here. >> thank you so much. >> and this now study was out and i don't think that it's a month old, i guess, in terms of the results and the nature? >> yes. >> and show had a piece recently, saying the news is electrifying the field. >> sure. >> and is it that exciting and why? >> i think it's exciting and we're treating the breast cancer the same for years in terms of dividing it up into stage 1, stage two, stage three, stage four and depending on the size of the tumor, you had standard treatments of timeo -- chemo therapy and hormonal therapies to block the production of estrogen. what this study is showing is that not all breast cancers are the same and we should be doing more to individualize the

therapy. . >> in other words, they tell you why stage one instead of stage four? >> not necessarily the different stage but the interest features of someone's tumor. >> uh-huh. >> and so can you target therapy individually. not just treating someone based on the stage of the tumor but based on the features about their tumor. >> uh. >> and it turns out that east breast cancer tumor has genes that code for certain proteins that are expressed on the surface of the breast tumor. >> you said genes. i'm wondering. we have heard is there a history of breast cancer in your family? you answer it on every questionary i am through it and i am thinking no, whatever. and what they say to you is don't let that stop you from getting the regular mammograms and so forth. and that, is any of that impacted by what we know in from the study?

>> and that is different in terms of there are joins that people carry that increase the risk of breast cancer and that is a small% of breast cancers and that might be due to known genetic mutations in people's jeeps. most people have a strong family history of breast cancer and you often times see ovarian cancer in the family and what this study was about is looking at the breast cancer tumor itself. looking at the pattern of proteins expressed, what is express on the surface of the tumor to allow us to target new treatments in a biologic fashion targeting them specifically for the type of breast cancer someone has. >> they evened, i think in the study, work -- correct me if i'm wrong, that some of the cancers might be similar to something look's lung cancer or other kinds of cancers. what they may give you for lung cancer, they can give you for breast cancer? >> sure. what they were tacking about is one of the four types that they

looked sat called triple negative cancer which, is not sensitive to hormones or estrogen, progesterone or another marker called her2mill. and they tend to be aggressive. what they're finding, what they found in the study is that behave not like the typical breast cancer but like ovarian cancer and that may lead towards looking at treatments that we typically use for ovarian cancer that might be useful to this specific type of breast cancer and that is targeting the individual and targeting the treatment towards the type of breast cancer they have and not just saying breast cancer. >> you said it may and that is the magic word i am hearing. says azsomeone who is a survivor other and women who are diagnosed soon or now, and you tend to wonder when will this technology, this information be implemented so that i can take advantage of it? >> yeah, i think that this

leads to many areas to be researched. and if you look at the triple negative tumors, i think that soon we may see breast cancer physicians, oncologies try using treatments that are typically used for ovarian cancer and realize that this is still preliminary and may take awhile before -- . >> yeah. >> we learn about this and this is still very -- . >> soon and awhile -- yo yeah. >> in the medical community and think that, and think next weekend, you would probably think, what a couple of years? >> and that might be southeastern. i think breast cancer research is happening rapidly and the findings get translated into clinical care at a fast rate and this is exciting. and it helps us understand more about how we should be treating people better, and i think that we'll so it fairly soon. >> will we have an impact on people coming through breast cancer who are survivors and

treated, lumpectomies, mastectomies, or any of the above cocktail and are hoping that that will come back. >> sure, as we learn about individual tumors, we learn about how to best treat them and there is still research ongoing and helping us to understand how long should we be treating hormoneally treated breast cancer sent it five or 10 years? and research may help us understand someone's individual time and are -- tumor and risk. >> we'll go through who should do what and when and how often and there is a glimmer of light and hope and something called 3d. there is a 2d and that is 2d, all right? what is that, left and right? front and back in.

>> and. >> it allows physicians or majoritiographers to look in a 3d physician and -- fashion. >> there is talk about an mri and can you do that, too, where you lie down on the machine and yes? >> right. >> mris are done in certain situations. it's a very, very sensitive technique for detecting small invasive breast cancers. one of the problems is that it has -- it's so sensitive that it has a high false positive rate. >> uh. >> and that is not and shouldn't be used for all women but high risk for breast cancer and who may carry one of the jeep mutation. >> and you get more people called back for recreeping? >> right. things that make them anxious, nervous, painful tests,

biopsies that turn out not to be necessary and may cause scarring to make examsence isible. >> yes. >> and the 3d is early. >> uh-huh. >> and has been fda approved and one of the problems is that it also seems to have a higher false positive rate. >> and when might we see it in san francisco? >> it's hard to say. and i think one of the years where 3d is useful is for younger women who have dense breasts and so the studies that have looked at that are suggesting that 3d mammograms, which, again, look at the breast from different dimensions and have a machine that goes over the women's breast and to give a better picture of the breast is useful, particularly in women who are younger with dense breasts. >> huh. >> and and i think there needs

to be more research looking at this before it's adopted widespread and as a basic screening tool. >> okay. we're going to take a break and come back and have more including the standard of treatment right now and what you should be doing. can you prevent breast cancer and what you should be doing at what age. when we return.

. >> welcome back. we're talking with mindy goldson and in addition to her practice, she has the fund which provides women with breast cancer. she would like us to say not alternative but complimentary options to improve the quality of life and we'll talk about that in a second. first of all, just a couple of quickies here. we heard in just about every conversation that i have had in this show about breast cancer with any doctor and that is always the peak that -- and women get this more so. is that still true and do we have an inkling as to why or is that still a mystery? >> that is not clear and there is some hypothesis raised and one is alcohol. and would have there been more and more studies suggesting that alcohol use, and particularly higher levels of alcohol. -- >> marin county women are

drinking to much, huh? >> and close to napa. >> huh. >> and why wouldn't it be that they get it more? >> that is a good question. >> we see it in certainly socioeconomic groups, higher educated and who don't have children or delay child bearing and turns out that marin has a higher preponderance of women who fit into that category. >> uh. >> and the other factor might be wine, might be one issue and one of the other factors might be and they have their ovaries out, they may go on estrogen to alleviate menopausal symptoms. >> uh-huh. >> and if they don't and decide to go on hormone replacement therapy to alleviate menopausal symptoms, they need to take a combination of estrogen and progesterone -- . >> not to send it into next week? >> and that is used to protect the uterus from routian cancer.

>> huh. >> you don't have one, you don't need it. >> and what if you have it out and didn't have the ovaries out? >> you may need treatments and the symptoms are severe. when you are looking at hormone replacement therapy, times -- seems like it may have more negative effects on the breast and one of the things that is common in marin is fewer women have hysterectomies and that might be part of it. fewer women having hick the rest -- hysterectomies and if they need hormones, they need the progestin and maybe the proximity and napa and more alcohol, other factors that we don't know. >> okay. >> and treatments now. and treatments now. i assume chemotherapy is one done. lumpectomy or mastectomy.

the women are having mastectomies and i had a cousin who elected to have the double mastectomy. >> sure. >> and i had a lumpectomy. >> yeah. >> and she did it for, i guess, other reasons and how do you feel about women doing this? >> or goal is to guide people about outcomes and talk toem about outcomes of lumpectomy versus mastectomy and lumpectomy has similar outcomes and a big thing is patient choice. >> uh-huh. >> and patients have to decide what is right for them. there are many people that may decide based on a family history and their desires, they want a double lumpectomy, or mastectomy. radiation, hormonal therapies, herceptin. i think some of the exciting

things that are going in treatment really come from that article what, it talked about and we're doing more individualization of therapy, figuring out who needs it and who doesn't so we don't overtreat people who may not have an aggressive tumor and be a higher risk of occurrence. >> okay, you have that up. >> yes. >> and that is a group that is dedicated to comp limitary options such as? >> reporter: what we do, is this is set up 12 years ago. her hawaiian name is ewilani and she had an aggressive tumor and found while going through treatment, if she did complementary care like chinese herbs, it gave her the energy to work out in the gym. and in the end, acupuncture and energy work alleviated the discomfort and after she passed away, a group of us got together and formed the fund in her memory and provide funding

specifically for complimentary care to improve call the -- quality of life of women going through breast cancer treatment. >> huh. >> and we're proud that after this year, we have given away 200,000 i can promote -- . >> and this is october 20th. >> uh. >> and we do a bikeathon in the santa cruz area and that is along the coast, inland and along watsonville and we have a 25, 45, and 65-mile opposition and. >> and that is on the screen. >> we're looking for ankles, too. >> okay, sounds good and that is a great time of the year and if you're in need or someone who does, at ualanifund.org. and we go want get to the

mastectomies and win and pretty much we know, don't we? >> and -- . >> whatem every year? >> forty to 50. >> check with your doctor and go in. when in doubt, ask and do it. it doesn't pay. dr. mindy goldman, thank you for being here. stay with us, more ahead.

. welcome back. domestic violence leads a life of fear and makes every day a nightmare. 35 years ago,la casade las

madres offered help to victims by becoming california's first and the nation's second shelter dedicated to women and children escaping a dodomestic violence and meet cathy black. her book is her story of dealing with abusive relationships and overcoming low self-e steve. how prevalent or common is domestic abuse in the bay area? >> 75% of the population -- three or four of us know someone who is a victim or one in three women. >> and when you say domestic violence or abuse of relationship. >> uh-huh. >> a lot of people think, oh, that must mean getting hit, i'm getting smacked around physical. >> right. >> and do you broaden that

definition? >> absolutely. it's intimidation, environmental, spiritual, economic -- very so -- there are so many different -- verbal abuse, psychological abuse -- it comes in many forms. >> uh-huh. >> you think people in this situation if they're not getting visually beaten. >> uh-huh. >> dismess all of the other definitions because that is a nice way to deny it's happening to them? >> right. i think the more education that is done, the more people are reaching out to explore what their options are and they hearing these two are acts of family violence or relationship violence and might be calling to explore what their options are and we say you don't have to leave your home to come to hours. we want to encourage victims. >> and that is veriesome.

and we heard that before and i am surprised it continues and girls today, they're savvier and more performed and have that technology. they're in connection and communication. why is this happening? >> i think that, you know, so much of it is about what wering what the healthy relationships are. if you're in a home where domestic violence is happening, you might think that is the norm. we're beginning to do a better job at a very young age. there are great programs in the school systems and stawing to kids about building healthy relationships. that is critical. again, one in four teens experience some sort of intimate dating violence and in their lifetime also. >> uh-huh. >> and you have written a book about this and work with women who are in these situations?

>> yes. >> okay, before we get to the work you do, tell me -- tell me a little bit about your sister story? what happened, briefly if can you. >> to make a long story short, i remember being at the end of a barrel of a gun. >> oh. and having my boyfriend at the time saying nobody will love you as much as i do. >> and he was pointing it at you? >> andy remember thinking the truth and that i hit the left bottom. >> did you know the relationship, did anything in your gut say this is not the thing? >> uh-huh. >> is that common? >> you would wonder, why would you get into a situation where with a person who is abusive? >> and i think it's common. we're tapping from ways to

reach individuals and have this great 35 lessons and we didn't have the kind of social media access we have to -- had to use in young women and women in relationships in the past there is a changing world. i think there is hope getting the red flags out there and talking about the situations so that other people don't end up in the same situation as anita. >> when they first started, and people brought it into the ocean, and she was afraid to leave, had has any of that changed? what are you hearing when you work with them? >> i am hearing more and more the negligencor emotional abuse. >> and what would be financial abuse in. >> no access to the financial

resources that is not uncommon for us to see the victims come in who don't have a access to their checking account. and going into an account and they have no way to access it. >> and partnership controls. >> you want money for groceries, you ask me. and whatever -- . >> okay. >> right. >> and going to the grocery store with that and so much so that they aren't allowed to shop on their own. >> and a couple -- opened 24/7. >> yes. >> year round. >> and you offer help to women who were not in crisis. if a woman calls you and how soon can you get her to years in danger to what you would give her? >> immediately. >> and that is 24/7, and we, obviously, if it's dangerous, we say hang up and call 911. >> yes.

>> and the alternative is we transport someone to a place immediately. >> and that is confiddennual. >> and that is difficult. >> part of that is when a victim gets to us and susound -- surrounded by other individuals in the same situation as they are and realize they not alone. >> uh-huh. >> they don't want to do anything that is jeopardizing someone else. >> does this cost anyone anything? >> no. >> 100% free. >> and the funding is from? >> and that is 50/50 public and private. so, we have some public grants and raise a lot of money presently. >> i wish we had more time. but thank you. her book is a woman's gurney from self-loathe to self-love. it happens with low self, steve. for more information aboutla

casade las madres, go tolacasa.org and there are phone numbers on the screen. you will notice one there,en to crisis. the line is on the screen as l. for more information about anita ross' workshop for adults, go to her website at anitaross.net. and we want to let you know there is a few weeks left at the yerba bueno gardens festival. we leave you now with some performers. thank you for watching.